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Robinson receives award from FAS organization

UB faculty member Luther Robinson was honored with the 2013 Excellence Award of the National Organization on Fetal Alcohol Syndrome in recognition of his career-long dedication to studying and screening children for the condition. Photo: Douglas Levere

By ELLEN GOLDBAUM

“I thought Buffalo was going to be a blip on my CV. I’ve been here 26 years.”

Luther Robinson, professor

Department of Pediatrics

Toward the end of his undergraduate days at Oberlin College in
1970, Luther K. Robinson, the son of a Ford plant worker and a
hospital housekeeper, who planned to go to medical school, was
given “the talk” by one of his professors.

“He said to me, ‘Do you know that it’s hard to
get into medical school?’” Robinson recalls. “I
told him yes, I knew that. He said, ‘You’re not the
strongest student in the division.’ I said I knew that, too.
He asked me, ‘what are you going to do if you don’t get
in?’ I told him that I was going to get in. He asked me how I
knew that. I told him, ‘Well, I’m going to be a doctor
and if I’m going to be a doctor, then I’m going to have
to go to medical school.’”

Robinson’s determination to pursue medicine has served him
well. Earlier this month, the professor of pediatrics in the School
of Medicine and Biomedical Sciences and the Division of Genetics at
Women & Children’s Hospital of Buffalo (WCHOB) was
honored with the 2013 Excellence Award of the National Organization
on Fetal Alcohol Syndrome in Washington, D.C.

He was recognized for his career-long dedication to studying and
screening children for fetal alcohol syndrome (FAS), advocacy for
better support for patients and the prevention of FAS. In addition
to his clinical practice, he has an active research program, funded
primarily by the National Institute on Alcohol Abuse and Addiction.
With national and international collaborators, he has conducted
screening and longitudinal studies of children with FAS in the
U.S., Africa and Europe.

After graduating with his medical degree from the University of
Cincinnati College of Medicine in 1974, Robinson served in the U.S.
Public Health Service in San Diego and then did his residency in
pediatrics at the University of California, San Diego. His plan was
to go into private practice. But then came his rotation with
Kenneth Lyons Jones, considered the father of the field of FAS,
first identified in 1973 by Jones and his mentor, David W. Smith,
at the University of Washington.

“Jones is an incredible teacher, who really invests in his
trainees,” says Robinson. “That rotation changed the
way I viewed my career.”

He held a postdoctoral fellowship in dysmorphology (birth
defects that lead to physical disabilities) under Jones and then
became assistant professor of pediatrics at the University of Texas
Medical School at Houston.

Robinson, who is board-certified in pediatrics and clinical
genetics, was interested in birth defects and how a mother’s
health affects the baby, particularly in the minority
community.

“One of the doctrines of the practice of medicine is that
early recognition improves outcomes,” he says. “I
wanted to help provide better recognition of genetic and
environmental disorders, especially in underrepresented
populations. The data suggest that FAS is more prevalent among
minorities but this is a preventable birth defect.”

In 1987, he took an assistant professor position at UB and at
WCHOB, attracted by what he recognized as the university’s
longstanding and nationally recognized tradition of clinical
excellence in the Department of Pediatrics.

“I thought Buffalo was going to be a blip on my CV,”
he notes, smiling. “I’ve been here 26 years.”

Robinson is director of dysmorphology and clinical genetics at
WCHOB; he works with other genetics professionals to meet the
diagnostic and treatment needs of patients with known or suspected
prenatal exposures to neurotoxic substances, such as alcohol.

Since he began studying FAS, he says the number of
cases—roughly 1 in every 1,000 live births in the
U.S—has either stayed constant or seen a slight increase. The
rate is especially high in poor urban and poor rural populations,
he says.

“We’ve known about fetal alcohol syndrome since 1973
but people get mixed messages,” he says. “They’ll
hear: ‘Have a glass of wine when you’re pregnant,
it’ll relax you’ or ‘Dark beer is good for your
milk.’ But there is no safe level of alcohol consumption
during pregnancy. The recommendation is: Just don’t drink
during pregnancy. Period.”

Fetal alcohol syndrome is a recognizable constellation of birth
and developmental disabilities, including small stature, slight
build, small eyes and smaller than normal head circumference.
Additional physical symptoms include improper development of the
space between the nose and upper lip.

But by far, the most detrimental result of fetal alcohol
syndrome is that it causes improper development of the nervous
system, leading to lifelong learning and developmental
disabilities.

“It’s not glaringly obvious which children have
fetal alcohol syndrome,” says Robinson, although specialists
can usually identify them by their facial characteristics.
“These are kids who are often described as willful,
impulsive, hard to manage. They are told by teachers and
administrators that they just have to work harder in school. But
with fetal alcohol syndrome, there has been an insult to the
developing brain that leads to these problems.”

Treatment for fetal alcohol syndrome is largely focused on
school and behavioral support for the child, including physical,
speech and occupational therapy provided by the New York State
Department of Health. Robinson’s division at WCHOB also works
closely with a support group for parents.

When diagnosing a patient, Robinson tells the mother that
alcohol crosses the placenta and can harm the baby. “I try to
depersonalize and destigmatize the birth mother,” he says.
“Both the child and the mother are in need of intervention.
Sometimes, the recognition of the child’s birth defect will
get the parent to change her behavior.”

However, most of the time, the caregiver Robinson is dealing
with is not the birth mother.

“In clinical practice, 90 percent of children diagnosed
with fetal alcohol syndrome are in foster or adoptive care,”
he says. “That statistic just underscores the disruptive
effect of alcohol.”

Robinson was an inaugural member of the Collaborative Initiative
on Fetal Alcohol Spectrum Disorders funded by the National
Institute on Alcohol Abuse and Alcoholism. He also has worked with
the New York State Department of Health Congenital Malformations
Registry in tracking the prevalence of birth defects.